Normal Sleep from 6 to 12 months

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For those concerned about their infant's short naps and night waking, a new study led by Dr. Pennestri at McGill adds to our knowledge that:
-Interrupted sleep in infancy is normal. 
-Consolidated sleep happens gradually over time. 
-Interrupted sleep is not correlated with developmental issues (contrary to some previous studies).

Pennestri’s study coincides well with a much older study (Scher, 1991) that showed an increase likelihood of regular night waking at 9 months of age: although 40% of babes were waking up regularly at 6 months of age, this increased to 60% at the 9 month mark, dropping only slightly to 55% by 12 months of age. These studies explain what many parents have experienced at this age and explains why a significant number of my clients call me by the 10 month mark, concerned and exhausted! This bump in the road might be explained by the enormous social and emotional changes that are happening at this age.

What does this mean for you and your little one? 
1. Biologically normal night waking can be approached through perspective changes, self care, and environmental adjustments to help nudge children gradually towards longer sleep periods. 
2. Listen to your instincts about whether there may be an underlying issue (colic, reflux, environmental and food sensitivities) --these can all be sleuthed out and addressed to bring sleep more in line with your child's natural sleep needs.
3. Lean in to what is normal for babies and soak this intense, amazing, draining, and exciting time in as a season of parenting that can feel tiring, but does not need to feel terrible.
4. Call for support! Even if your baby is sleeping "normally", it can be helpful to have someone support your efforts through evidence, reflection, suggestions, and guidance. Sometimes the best intervention is through understanding.

Because there are significant (and often challenging) changes to infant sleep between 6 and 12 months, expect further articles of the research on “what is normal” for this age range soon! And even though it is hard to “rest” assured, most babes are shifting towards more regular and longer sleep periods by the one year mark. Better sleep is ahead!

Resources:

The McGill study, by Dr. Pennestri et. al., is in the December 2018 issue of Pediatrics. and is reported in McGill.ca, November 2018. Parents shouldn’t worry if their infant doesn’t sleep through the night by 6-12 months of age

Scher (1991). A longitudinal study of night waking in the first year. Child: Care, Health, and Development, 17 (295-302).


 Photo Source: Pixababy yc0407206360

Photo Source: Pixababy yc0407206360

Even With Older Children, Attachment and Connection Support Sleep

 A photo from quite a few years back of a relaxed and joyful part of our bedtime routine —hanging out together. Sleep is important. And so is connection. The two can work together. (It is recommended that children under two not bed share next to a sibling.)

A photo from quite a few years back of a relaxed and joyful part of our bedtime routine —hanging out together. Sleep is important. And so is connection. The two can work together. (It is recommended that children under two not bed share next to a sibling.)

There was a time before kids when I was not as attachment-focused in my sleep approach. And if I am completely honest with myself, there have been times even after becoming a mother where I have struggled with attachment-based approaches to supporting sleep. Shifting my perspectives and expectations this much has been a process.

But now, with my youngest at age 4, and with my two older boys, I’ve hit my stride (without perfection, but with calm intention) when it comes to supporting their sleep most nights.

Tonight’s bedtime routine (with all it’s imperfections, and bumps) feels like a story worth telling, in that it reflects how profoundly I’ve shifted my priorities around night time parenting. I don’t dismiss the importance of sleep (enough of it, and of good quality). But I do know that more often than not the best way for our kids to get good sleep is to meet (and exceed) the need with an open heart and a calm, unhurried state of mind.

Perhaps some nights an open heart and a calm, unhurried mind are a struggle. On those nights it’s a challenge to dig deep and meet the need. It becomes a war against our intentions, which often comes out looking like a battle against our kids: them resisting sleep, and us trying to overpower their resistance.

But tonight there was no strong arm, no temptation to coerce, and no resistance. Instead, the evening started with rather feeble efforts on my part to start the routine, and ended with a sense of such connection that I am smitten.

At the usual bedtime, as I do on nights when I am distracted and trying to get work done, I was verbally guiding my two older kiddos (6 and 9) to bed. But as with so many pieces of parenting, you’ve got to walk the walk….and actually walk with them upstairs! Instead, I was giving instructions about shutting down screen time while tapping on my laptop, and listing off bedtime steps without modelling them myself. Hardly “leading by example”.

Now I do know that my children are capable of walking up stairs independently. Of brushing their teeth independently. Of getting dressed independently. Of climbing into bed and crawling under the covers independently. But I have learned well both through research and through parenting experience, that the ability to do something independently is not the only factor in accomplishing a task. Not by a long shot. Coming alongside, and “doing with” are powerful strategies for connecting and accomplishing.

So instead of escalating the volume of my voice, getting sharper and snappier and frustrated, I paused, and heeded the call from my spouse to please come upstairs and help usher them to bed (we both play integral parts in the bedtime wind-down) —tonight things weren’t going all that smoothly. There seemed to be a frenetic energy in the upstairs loft (full moon?!). A lot was happening that had very little to do with bedtime. There were push ups and jumping jacks, karate punches and kicks into cushions, building of forts, requests to make elaborate paper plate faces to tape to these “punching bags” (yes that sounds terrific; yes, it will have to wait till tomorrow), and a lot (a lot) of talking.

But step by step, slowly and calmly, we made our way to their beds where story time was pulled off the roster but gratitude questions and a review of their day remained intact. By now it was very late and despite having more work to take care of, I lay with them a while, and I closed my kindle (did I say screens shouldn’t be part of bedtime? Direction not perfection!), and just lay there as my middle child told me elaborate explanations of how things work. He chatted while holding my hand. His volume was louder than usual, and we kept having to remind him that his little brother was sleeping. He talked with excitement and enthusiasm and while he talked he played with my hair. And then, interrupting his story, he requested that I get the detangling brush….so that he could brush the knots out of my hair.

Now the old me —before I became a mother, or before we got to a point where I was getting enough sleep most nights to make flexibility and patience easy— would have said no, it’s bed time, good night. But tonight I paused, considered how comfortable and content he was: he was getting one-on-one time with me as he peered at the full moon out his window and lazily shared contemplative explanations of zombies and werewolves.

Here was a kiddo whose one-on-one time often gets squeezed out between the needs of his younger brother and the activities of his older brother. The kiddo who sometimes stops talking out of frustration that no one is listening, or that he’s been interrupted again. Here he was chatting to me, connecting with me. So I did what I felt compelled to do: I got the comb, I brought it up, and he combed my hair while talking, while solving dilemmas of his day, while unwinding for sleep.

When all the knots were out I said good night, gave the boys kisses, and left. They both fell asleep without another peep.

There is something liberating about approaching night time this way. For all the conflict, or upset, or missed opportunities to connect during the day, night time has fewer distractions. Night time is a chance to put a cherry on top of the day, no matter how bad the day has been. Night time could be (and often is!) a stressful, exhausting ritual of resistance when we as parents can be maxed out. But by “finishing strong”, and finishing with connection, I’ve made up for some of the less-than-ideal parts of today.

Whatever needs he had not had filled during the day seemed topped up well by my spending this time with him as he lay in bed. And his need for sleep is fulfilled too: maybe not as early as ideal, but certainly as smoothly as I could ever wish for.

 Snug as kittens: even older kiddos need to feel relaxed and to unwind with parental support sometimes.

Snug as kittens: even older kiddos need to feel relaxed and to unwind with parental support sometimes.

Reflections on Parenting

I recently took some time to reflect on what my priorities are in supporting parents with infants and young children. I wanted to hone in on what message I am really trying to share with families, regardless of whether we connect about infant sleep, development, or parenting. Whether family life is going along tickity-boo, or whether things feel like they are falling apart at the seams, these thoughts are ones I turn to to help me have perspective, and to have trust in the process.

This work is important to me. And I’m honoured to get to come along with you on your parenting journey as your OT when you reach out to me for support.

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Holiday Gift Giving: Re-thinking, Re-prioritizing, and Re-gifting

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Holiday Gift Giving : Re-thinking, Re-prioritizing, and Re-gifting
 

When we think of Christmas time we think of an abundance of joy, toys, wrapping paper scattered happily everywhere, and excited squeals of delight.

The reality may be quite different: overcharged credit cards, disappointed gift receivers who didn't get the latest toy, an overwhelming and cluttered play space, and toys that go untouched after the initial excitement is over.


It may be worthwhile, before preparations for the holidays go into full swing, to reflect on your priorities and your vision of what gift giving could be like in your family.  It is an especially good time to give this some thought if you are expecting a birth in the coming months, or if your children are very young.  Setting your family's intentions around gifts and toys early is easier, and can set the stage for many years to come.

If the idea of abundance and meaningful toys without the clutter is appealing, enjoy the links below this article about how to make the shift to more meaningful and minimalist gift giving in your home.  And if you would like exploring this idea more, send me an email ....I’d be pleased to organize a workshop to explore ideas around gift-giving in the new year (when you have lots of time to think about things for next year!). Simplicity is a central value of mine and one that can shift our thinking from how to buy the ‘right’ toy to:

  • How to choose developmentally appropriate toys that last;

  • How to enjoy the abundance of gift-giving while moving towards minimalism; 

  • The love language of gift giving and why it can be a wonderful thing and a challenge;

  • Gift giving traditions based on simplicity.

Heather

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Resources for Giving in Meaningful Ways:

https://www.happysimplemom.com/minimalist-gifts-for-kids/

Parentshttps://www.parents.com/fun/toys/baby-toys/your-guide-to-age-appropriate-toys/

https://www.friendshipcircle.org/blog/2014/04/30/the-five-types-of-toys-for-children-with-special-needs/


https://www.simplicityparenting.com/gift-giving-and-receiving-with-simplicity-and-relationships-in-mind/

Infant Mental Health

Infant Mental Health: A primary goal of attachment-based parenting

Early in my career as an occupational therapist, I had the privilege of participating in York University's inaugural Infant Mental Health certificate program.  The focus was on understanding the environmental and biological basis for infant mental health. 

Since that time I have studied the science of attachment theory and ecology, and learned the impact of our parenting approaches on infant mental health. What has struck me most across all of this learning was appreciating the impact that our environment can have on the developmental well-being of infants and young children. Our children’s environments are largely created but us in the early years, and we have a significant influence on how nurturing their environments are.

Nurturing, stable, safe, and loving environments can have a positive influence on children, including those with a history of trauma. Although we cannot change the past, what we do today to shift towards more nurturing environments can support infant mental health.


The passion I have for connected parenting in the early years and beyond is reflected heavily in my approach to supporting infant sleep.  Sleep deprivation can make even the most patient parent short-tempered and less compassionate.  Sleep-deficient infants are more easily upset, more 'wired', and often more difficult to get to sleep.  And yet, at the heart of it, infants need proximity to a loving adult who has the capacity to parent in a nurturing way. It is helpful to listen to our instincts about how to support their biological and emotional needs, and to seek support (from family, from friends, from skilled mental health care professionals) to do that.

My approach to infant sleep is to inform, to guide decisions, and to change the environment and expectations in order to progress towards sleep practices that support everyone's sleep needs.  For families who have additional challenges, including mental health issues, and trauma history, I connect families with local health care professionals who can continue to support families in ways that respect the family's needs and goals.

Understanding the huge impact that we, as parents, have on our children’s well being is not intended to add a burden. Rather, it can help make decisions easier: we can choose to meet the need. We can choose to connect. We can choose to be present with our children. And we can choose to take care of ourselves and to get support when we feel overwhelmed.

Key Messages:

  1. Attachment based parenting improves infant mental health.

  2. Our environment impacts our health.

  3. Decisions are easier when we know why attachment is important.

  4. Self-care is critical: fill your own cup so you can fill theirs too.

I am not a mental health professional. But there are talented and compassionate people in our community who are. If you are concerned about mental health and about your capacity to support a nurturing relationship with your child, reach out and seek support.

Niagara Resources:

In Niagara, local supports for infant and family mental health include:

  • Pathstone Mental Health Services, pathstonementalhealth.ca

  • Emily Pollak, Social Worker, individual and family counselling, St. Catharines, emilypollak.ca

  • Niagara Infant Mental Health website (Early Childhood Community Development Centre), http://www.eccdc.org/infant-mental-health/

Within and beyond Niagara, supports include:

  • 911 for medical emergencies

  • 411 for information about local mental health services in some jurisdictions

  • Your family physician

  • Local initiatives to support infant and child mental health